In collaboration with your approved course mentor, identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website. Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following: 1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project 2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed. 3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need. 4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes. 5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing. 6. A proposed solution to the identified project topic You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment. Here is a PICO which could be used or a variation of it. “For direct patient care, does lower patient to nurse ratio improve nurse esteem and decrease burnout and decrease errors, injury, and attrition?” An essay you can use for reference. The problem The nursing shortage is a significant issue affecting healthcare facilities across the world. In the homes for the elderly, research by Baumbusch et al. (2016) indicated that the ratio of patients to nurses needs to be balanced to ensure that the quality of services provided is high. For elderly patients, the research showed that they are prone to frequent falls if not carefully monitored, guided, and supported in their daily routines. With the shortage of nurses, the main problem has been frequent falls among the elderly patients. As highlighted in a study by Parke & Hunter (2014), mandatory nurse-patient ratios have been a persistent problem in healthcare. It is an issue that has raised concern among the different stakeholders including patients, nursing organizations, nurses, the government, and researchers. The setting The number of elderly patients in Texas health care centers is increasing every day. This is centers where the elderly are enrolled seeking for advanced care that the family and relatives are unable to provide given their busy schedule. In these centers, the elderly receive care including medications, physical therapy, counseling, and other forms of treatments. Reports from a study by Donald et al. (2013) indicated that such centers provide shelter to thousands of the elderly patients mainly from the ages between 45 and above. A description of the problem In such a setting, having the number of the elderly increasing every day, there is a need to increase the number of nurses. As noted by Liang et al. (2012), the elderly patients are fragile and have more needs compared to the younger patients. Therefore, they require personalized care which can only be provided by highly skilled and experienced nurses. However, as the number of the elderly increases, the challenge is that the number of nurses remains the same. In this context, it means that the ratio of patients to nurses is widening with the number moving from one nurse per five patients to one nurse per ten patients. This is a significant problem given that nurses may be overwhelmed in the delivery of care by the huge number of patients they are expected to serve. Impact of the problem Having a nursing shortage in any healthcare facility is a major challenge in the delivery of quality care. As indicated by Baumbusch et al. (2016), the nurses have enough energy, time, and resources to provide care to a definite number of patients. If the nurses are overwhelmed by the number of patients, they could burn out or lack the motivation to provide quality care. Issues of fatigue, medication errors, and increased falls among the elderly were reported in a study by Parke & Hunter (2014) with arguments that the nurses were few compared to the number of patients. It is therefore clear that if the nursing shortage in elderly homes is not addressed, the welfare of the elderly is at risk given the possibility of inadequate support from the nurses. Significance of the problem Addressing the issue of nurse shortage is critical in improving the quality of service delivered to the patients. In the context of the current problem, having more nurses in the healthcare center will ensure that the elderly are provided with care and support all the time. It means that the number of falls will reduce if the nurses can support every patient in their daily routines. As noted by Parke & Hunter (2014),